The efficacy of suprapatellar, parapatellar and infrapatellar intramedullary nailing in the treatment of tibial fractures: a systematic review and meta-analysis

Background Tibial fractures are common and challenging orthopedic injuries that are commonly treated with intramedullary nailing techniques via suprapatellar (SP), parapatellar (PP), and infrapatellar (IP) approaches. This study aimed to provide a comprehensive comparative analysis of the efficacy o...

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Published in:Archives of orthopaedic and trauma surgery 2024-11, Vol.144 (11), p.4917-4927
Main Authors: Lu, Ke, Wu, Zhi-Qiang, Qian, Rong-Xun, Gao, Yi-Jun
Format: Article
Language:English
Subjects:
Adult
Archives & records
Bone Nails
Cartilage
Clinical outcomes
Clinical trials
Cohort analysis
Female
Fracture Fixation, Intramedullary - methods
Fractures
Humans
Knee
Knee Arthroplasty
Male
Medicine
Medicine & Public Health
Meta-analysis
Operative Time
Orthopedics
Pain
Patella - injuries
Patella - surgery
Patients
Quality of life
Surgery
Surgical outcomes
Systematic review
Tibial Fractures - surgery
Trauma
Treatment Outcome
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Summary:Background Tibial fractures are common and challenging orthopedic injuries that are commonly treated with intramedullary nailing techniques via suprapatellar (SP), parapatellar (PP), and infrapatellar (IP) approaches. This study aimed to provide a comprehensive comparative analysis of the efficacy of different treatment approaches based on clinical outcomes. Methods We conducted a detailed search in PubMed, Cochrane Library, Embase, and Web of Science for clinical studies comparing suprapatellar, parapatellar, and infrapatellar approaches in intramedullary nailing of tibial fractures. Inclusion criteria included randomized controlled trials and retrospective cohort studies involving patients aged 18 and older, comparing outcomes of these surgical techniques. Exclusion criteria included studies with insufficient data, non-English publications, and those focusing on non-tibial fractures. Results A total of 15 studies involving 1396 patients were included in meta-analysis. Pooled results indicated that, compared to IP nailing, the SP approach significantly reduced fluoroscopy time (MD = − 35.63, 95% CI − 39.37 to − 31.89, p 
ISSN:1434-3916
0936-8051
1434-3916
DOI:10.1007/s00402-024-05584-z